Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
| Autor: | Kshitij Chatterjee, Jacob T. Painter, Catherine A. Killingsworth, Bradley Boye, Rose E. Pennick, Drayton A. Hammond, Nikhil Meena |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
lcsh:RS1-441 Pharmaceutical Science Inappropriate Prescribing Pharmacy 030204 cardiovascular system & hematology Pharmacists digestive system lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine fluids and secretions mesh:Intensive Care Units Formal education Intervention (counseling) polycyclic compounds Medicine 030212 general & internal medicine mesh:Pharmacists mesh:Academic Medical Centers Intensive care medicine Adverse effect mesh:Retrospective Studies Retrospective Studies Original Research mesh:Anti-Ulcer Agents Academic Medical Centers mesh:Inappropriate Prescribing Critically ill business.industry Stress ulcer lcsh:RM1-950 virus diseases Retrospective cohort study Anti-Ulcer Agents medicine.disease United States digestive system diseases Intensive Care Units lcsh:Therapeutics. Pharmacology Educational interventions mesh:United States business Cohort study |
| Zdroj: | Pharmacy Practice Pharmacy Practice, Vol 15, Iss 3, Pp 948-948 (2017) Pharmacy Practice (Granada), Volume: 15, Issue: 3, Article number: 948, Published: SEP 2017 Pharmacy Practice (Granada) v.15 n.3 2017 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1885-642X |
| Popis: | Background: Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). Objective: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. Methods: A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU) at an academic medical center between January to June of 2014 (no intervention) and January to June of 2015 (intervention) was conducted. The percentage of patients prescribed inappropriate AST, inappropriate AST at ICU transfer and hospital discharge, doses of inappropriate AST, and adverse effects associated with AST use were compared between periods using chi-square tests. Results: Patients in the intervention group (n=118) were 5 years older than patients in the no intervention group (n=101). AST was inappropriately initiated more frequently in the no intervention group (23% vs. 11%, p=0.012). Continuation of inappropriate AST at ICU transfer and hospital discharge was similar between groups (60% vs. 53%, p=0.277 and 18% vs. 14%, p=0.368, respectively). Conclusion: Patients had appropriate AST initiated and inappropriate AST withheld more frequently when formal education was provided. This low-cost intervention strategy can be implemented easily at institutions where pharmacists interact with physicians on rounding services and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations. |
| Databáze: | OpenAIRE |
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